JP2008017859A - Ultrasonic endoscope and accessory raising base used for ultrasonic endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic endoscope configured such that the accessory of a large diameter can be used and a puncture needle can be accurately punctured to the desired part of a subject part without increasing the diameter of an insertion part. <P>SOLUTION: The ultrasonic endoscope comprises: an accessory insertion channel 23 which is formed at a thin and long insertion part and to which the accessory is to be inserted; an ultrasonic vibrator 15 disposed at the distal end of the insertion part to be used when imaging ultrasonic images; and the accessory raising base 27 provided facing the distal end opening 23k of the accessory insertion channel 23 at the distal end for adjusting the projection angle of the accessory projected from the distal end opening 23k by swing. On the accessory raising base 27, at least two accessories introducing surfaces 120 and 130 having mutually different angles to the insertion shaft J of the insertion part are serially provided along the insertion shaft J, and grooves 120m and 130m of different sizes are formed on the respective introducing surfaces 120 and 130. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an ultrasonic endoscope provided with an ultrasonic transducer disposed at the distal end portion of an insertion portion and used for capturing an ultrasonic image that is a tomographic image of a region to be examined, and the ultrasonic endoscope The present invention relates to a treatment tool elevator used for a mirror.

  2. Description of the Related Art In recent years, an ultrasonic endoscope in which an ultrasonic transducer that performs ultrasonic transmission and reception in addition to an image sensor is put into practical use at the distal end of the endoscope. In this ultrasonic endoscope, in addition to a normal endoscopic observation image obtained by imaging the surface of the body cavity wall at the site to be examined, an ultrasonic observation image that is a tomographic image inside the body cavity wall can be obtained.

  The specific configuration of the ultrasonic endoscope apparatus including the ultrasonic endoscope will be briefly described. The ultrasonic endoscope apparatus includes an ultrasonic endoscope and an illumination that is a peripheral device of the endoscope. The main part is composed of a light source device that supplies light, an ultrasonic observation device, and an endoscope observation device.

  The ultrasonic endoscope includes an elongated insertion portion, an operation portion connected to the proximal end side of the insertion portion, a flexible universal cord extending from the operation portion, and the universal cord The main part is composed of an endoscope connector provided at the base end.

  For example, a plurality of ultrasonic transducers, imaging elements, light guide tips, and the like are disposed at the distal end portion of the insertion portion. From the distal end portion to the endoscope via the insertion portion, the operation portion, and the universal cord Each medium transmission cable is extended to the connector.

  Specifically, a plurality of ultrasonic cables connected to a plurality of ultrasonic transducers, an imaging cable connected to an imaging element, a light guide, and the like are extended. In general, the plurality of ultrasonic cables are bundled and extended, for example.

  Further, a treatment instrument insertion channel through which a treatment instrument such as a known drainage tube or a puncture needle is inserted is formed in the insertion portion, and the distal end portion is located at a portion facing the distal end opening of the treatment instrument insertion channel. Is provided with a treatment instrument raising base for adjusting the protrusion angle of the treatment instrument protruding from the distal end opening by swinging.

  In the endoscope connector, the ultrasonic observation device can be connected to an ultrasonic cable, the endoscope observation device can be connected to an imaging cable, and the light source device can be connected to a light guide.

  In addition to the normal endoscopic observation image as described above, an ultrasonic observation image can be obtained, and the projection angle of the treatment tool on the introduction surface of the treatment tool raising base due to the swinging of the treatment tool raising base. An ultrasonic endoscope having a configuration capable of adjusting the angle is disclosed in Patent Document 1, for example.

In the ultrasonic endoscope disclosed in Patent Document 1, the treatment instrument has a configuration in which no shear force is applied to the puncture needle from the treatment instrument raising base at any raising angle of the treatment instrument raising base. The structure which can adjust appropriately the protrusion angle of a puncture needle by having a raising stand is disclosed.
Japanese Patent Application Laid-Open No. 9-122067

  By the way, since the treatment instrument such as a drainage tube having a larger diameter than the puncture needle is also inserted into the treatment instrument insertion channel described above, the channel diameter of the treatment instrument insertion channel is formed in accordance with the diameter of the large treatment instrument. It is common that

  However, if the treatment instrument insertion channel is formed with a large diameter, the puncture needle is formed with a smaller diameter than the drainage tube. When doing so, the puncture needle swings in the treatment instrument insertion channel.

  As a result, there is a problem that it is difficult to adjust the protrusion angle of the puncture needle by the introduction surface of the treatment instrument raising base, and it is difficult to accurately puncture the puncture needle to the desired site of the test site.

  In view of such a problem, a configuration in which a channel through which a large-diameter treatment tool and a puncture needle are inserted is separately considered. However, when two channels are provided in the insertion portion, the diameter of the insertion portion becomes large. Therefore, it is not preferable.

  The present invention has been made in view of the above problems, and can use a treatment instrument having a large diameter, and can insert a puncture needle at a desired site of a test site without increasing the diameter of the insertion portion. It is an object of the present invention to provide an ultrasonic endoscope having a configuration capable of accurately puncturing, and a treatment instrument elevator used for the ultrasonic endoscope.

  In order to achieve the above object, an ultrasonic endoscope according to the present invention includes a treatment instrument insertion channel through which a treatment instrument formed in an elongated insertion section is inserted, and a subject disposed at a distal end portion of the insertion section. An ultrasonic transducer used for imaging an ultrasonic image that is a tomographic image of a region, and the treatment tool that protrudes from the distal end opening and that faces the distal end opening of the treatment instrument insertion channel of the distal end portion A treatment instrument raising base that adjusts the projection angle of the insertion section by swinging, and at least two treatment instrument introduction surfaces having different angles with respect to the insertion axis of the insertion portion on the treatment instrument raising base. The grooves are provided in series along the insertion axis, and grooves having different sizes are formed for each introduction surface.

  In order to achieve the above object, the treatment instrument elevator used in the ultrasonic endoscope according to the present invention is provided facing the distal end opening of the treatment instrument insertion channel through which the treatment instrument formed in the elongated insertion portion is inserted. Introduction of at least two treatment instruments having different angles with respect to the insertion axis of the insertion part in a treatment instrument elevator that swings and adjusts the projection angle of the treatment instrument projected from the distal end opening Surfaces are provided in series along the insertion axis, and grooves having different sizes are formed for each of the introduction surfaces.

  According to the present invention, it is possible to use a treatment instrument having a large diameter, and to accurately puncture a puncture needle at a desired site of a test site without increasing the diameter of the insertion portion. It is possible to provide an ultrasonic endoscope having a treatment instrument raising base used for the ultrasonic endoscope.

  Embodiments of the present invention will be described below with reference to the drawings.

  FIG. 1 is a diagram schematically illustrating the configuration of an endoscope apparatus including an endoscope according to an embodiment of the present invention.

  As shown in FIG. 1, an ultrasonic endoscope apparatus 100 includes an ultrasonic endoscope (hereinafter simply referred to as an endoscope) 1, a light source device 3 that is a peripheral device of the endoscope, and an ultrasonic observation apparatus 4. The endoscope observation apparatus 5 and the monitor 8 constitute a main part.

  The endoscope main body 1h of the endoscope 1 has an elongated insertion portion 11, an operation portion 12 connected to the proximal end side of the insertion portion 11, and a flexibility extended from the operation portion 12. The main part is comprised from the universal cord 13 which has, and the endoscope connector 14 provided in the base end part of this universal cord 13. FIG.

  The insertion portion 11 includes a hard distal end portion 17 provided with an ultrasonic transducer 15 and an image sensor 16, a bendable bending portion 18 connected to the proximal end side of the distal end portion 17, and the bending portion. The main part is comprised by the elongate flexible tube part 19 which has the softness | flexibility provided in a line by 18 base end side.

  A plurality of, for example, 100 ultrasonic transducers 15 are arranged at the distal end portion 17 and are used as a unit for imaging an ultrasonic observation image that is a tomographic image of a region to be examined. The imaging device 16 is a known device such as a CCD that is used when capturing an endoscopic image that is a front image of a region to be examined.

  The endoscope connector 14 is provided with an ultrasonic connector 21 and an imaging connector 22. An ultrasonic electric cable 6 connected to the ultrasonic observation device 4 is electrically connected to the ultrasonic connector 21, and an endoscope connected to the endoscope observation device 5 is connected to the imaging connector 22. The electrical cable 7 is electrically connected.

  The ultrasonic observation device 4 generates a drive signal for driving the ultrasonic transducer 15, and generates an ultrasonic electric cable 6 and an ultrasonic transducer cable 50 (described later) that extends into the endoscope body 1 h. The drive signal is transmitted to the ultrasonic transducer 15 via FIG.

  Further, the ultrasonic observation device 4 performs ultrasonic processing based on the ultrasonic image signal transmitted from the ultrasonic transducer 15 via the ultrasonic transducer cable 50 (see FIG. 3) and the ultrasonic electric cable 6. A video signal for the sound wave observation image is generated, and the ultrasonic wave observation image is displayed on the monitor 8.

  The endoscope observation apparatus 5 generates a drive signal for driving the image pickup device 16 and generates an endoscope electric cable 7 and an image pickup cable 40 (described later with reference to FIG. 2) that extends into the endoscope body 1h. ) To transmit the drive signal to the image sensor 16.

  In addition, the endoscope observation apparatus 5 is configured to receive an endoscope observation image based on a captured image signal transmitted from the imaging element 16 via the imaging cable 40 (see FIG. 2) and the endoscope electrical cable 7. Video signal is generated, and an endoscopic observation image is displayed on the monitor 8.

  The light source device 3 supplies illumination light to a region to be examined via a light guide 60 (see FIG. 2), which will be described later, extended into the endoscope 1.

  Next, the structure of the insertion part 11 including the front-end | tip part 17 is demonstrated using FIG. 1 mentioned above and FIGS. 2 is a partially enlarged plan view of the distal end side of the insertion portion of the endoscope of FIG. 1, FIG. 3 is a partial sectional view of the distal end side of the insertion portion along the line III-III in FIG. 2, and FIG. 4 is a cross-sectional view of the insertion portion along line IV-IV in FIG.

  5 is a partial plan view of the treatment instrument elevator shown in FIG. 3 as viewed from the direction V in FIG. 3, and FIG. 6 is a partial plan view of the treatment instrument elevator as viewed from the direction VI in FIG. 7 is a partial enlarged cross-sectional view of the insertion portion mainly showing the connection portion between the connection pipe and the tube of FIG. 3, and FIG. 8 is a partial enlarged cross-sectional view of the tube in the vicinity of the connection portion of FIG.

  Further, FIG. 9 is a cross-sectional view of the front end portion showing the cross-section taken along line IX-IX and the cross-section taken along line IX′-IX ′ in FIG. 3, and FIG. 10 is taken along line XX in FIG. FIG. 11 is an enlarged plan view of the ultrasonic transducer cable of FIG. 3.

  As shown in FIGS. 1 and 2, the outer peripheral surface of the distal end portion 17 is formed with a concave notch 29 having one outer peripheral surface cut out, and a treatment is provided on the surface of the notch 29. A channel opening 23k, which is a tip opening at the tip 17 of the instrument insertion channel 23 (see FIG. 3), is provided.

  Further, on the surface of the notch 29 and in the vicinity of the channel opening 23k, an imaging window 34 or a light guide 60 (see FIG. 1) disposed on the front end side of the imaging device 16 such as a CCD (see FIG. 1). 2) and an air supply / water supply port 37k which is an opening in the front end portion 17 of the air / water supply conduit 37 (see FIG. 4).

  Further, in order to inflate a balloon (not shown) connected to the tip portion 17 on the outer peripheral surface of the tip portion 17 opposite to the surface provided with the notch 29, water is supplied to the balloon. A balloon water supply nozzle 38n in the balloon water supply line 38 (see FIG. 4) and a balloon suction nozzle 39n in the balloon suction line 39 (see FIG. 4) for sucking from the balloon in order to contract the balloon are provided.

  As shown in FIG. 3, the distal end portion 17 is provided with a distal end hard portion 31 made of, for example, metal or resin. A long hole 31a is formed in the distal end hard portion 31 along the insertion direction, and a connection pipe 43, which is a pipe member communicating with the treatment instrument insertion channel 23, is fitted into the long hole 31a. A distal end of a tube 44, which is a cylindrical member made of, for example, a fluororesin, having a treatment instrument insertion channel 23 in its lumen is fixed to a connection portion 143 on the proximal end side of the connection pipe 43.

  The diameter of the treatment instrument insertion channel 23 is formed to be the same as or slightly larger than the maximum diameter of the treatment instrument that passes through the channel 23. Specifically, in the present embodiment, it is formed to be the same as or slightly larger than the outer diameter of the drainage tube.

  Further, the inner diameter of the connection pipe 43 is formed larger than the inner diameter of the tube 44 other than the connection portion 143 between the connection pipe 43 and the tube 44. According to this, the treatment tool passing through the treatment instrument insertion channel 23 in the connection portion 143 is prevented from being caught on the proximal end of the connection pipe 43.

  In addition, as shown in FIG. 3, the outer periphery of the tube 44 in the vicinity of the connection portion 143 may be covered with a heat shrinkable tube 149. According to this, the hardness of the tube 44 in the vicinity of the connection portion 143 becomes harder than the hardness of other portions of the tube 44 by the heat shrinkable tube 149, so that the inside of the treatment instrument insertion channel 23 in the connection portion 143. The treatment tool that passes through is prevented from being caught on the proximal end of the connection pipe 43.

  Furthermore, as shown in FIGS. 7 and 8, a coil 155 may be wound around the outer periphery of the tube 44 in the vicinity of the connection portion 143. As a result, a hard portion 44k around which the coil 155 is wound and a soft portion 44y around which the coil 155 is not wound are alternately formed along the insertion direction on the outer periphery of the tube 44 in the vicinity of the connection portion 143. That is, a part with non-uniform hardness is formed.

  Accordingly, the treatment instrument passing through the treatment instrument insertion channel 23 in the connection portion 143 passes while being crushed by the soft portion 44y, and thus the treatment instrument passing through the treatment instrument insertion channel 23 in the connection portion 143. The connection pipe 43 is prevented from being caught on the proximal end.

  Returning to FIG. 3, an accommodation chamber 45 formed in communication with the connection pipe 43 having a channel opening 23 k is formed at the distal end portion 17 on the distal end side of the connection pipe 43. Further, a treatment instrument raising base 27 is disposed.

  The treatment instrument raising base 27 is extended to the inside of the insertion portion 11 by a turning operation of an operation knob 35 (see FIG. 1) disposed in the operation portion 12, and a protective tube 30c (see FIG. 4) on the outer periphery. Is known to change the directing direction of the treatment instrument which is raised and lowered by protruding through the channel opening 23k by being swung through the covered raising wire 30 (see FIG. 3) It is.

  The treatment instrument elevator base 27 has a substantially triangular cross section and is pivotally attached to one end pivot support 28 located at the bottom of the storage chamber 45 provided at the distal end hard part 31. For this reason, the other end portion rotates in the accommodation chamber 45.

  An introduction surface 140 for guiding various treatment tools to the channel opening 23k is formed on the surface of the treatment tool raising base 27 facing the channel opening 23k.

  The introduction surface 140 is formed so as to have a smaller angle with the insertion axis J as it goes toward the distal end side along the insertion axis J. In the present embodiment, the introduction surface 140 extends along the insertion axis J. And two introduction surfaces 120 and 130 provided in series. The introduction surface 140 may be composed of three or more surfaces.

  The introduction surfaces 120 and 130 are surfaces having different angles with respect to the insertion axis J of the insertion portion 11, specifically, the introduction surface 120 is formed between the insertion axis J and the introduction surface 130. The treatment instrument raising base 27 is formed on an inclined surface having a small angle.

  The introduction surface 130 is a surface that guides a large-diameter treatment tool, for example, a known drainage tube, to the channel opening 23k. As shown in FIG. 6, the introduction surface 130 has a maximum outer diameter of the drainage tube. An arcuate groove 130m into which the drainage tube is introduced is formed.

  The introduction surface 120 is a treatment instrument having a smaller diameter than the drainage tube, for example, when the drainage tube has an outer diameter of about 3.2 mm, a known puncture needle having an outer diameter of about 1.8 mm is passed to the channel opening 23k. As shown in FIG. 5, an arcuate groove 120m having a smaller outer diameter than the groove 130m into which the puncture needle is introduced is formed on the introduction surface 120. ing.

  That is, the maximum diameter of the groove formed on the introduction surface 140 is formed on the outer diameter of the drainage tube, and the minimum diameter is formed on the outer diameter of the puncture needle.

  The grooves 120m and 130m are not limited to an arc shape, and may have a partially arc shape or a tapered surface, for example, a V shape, or any shape.

  Further, a long hole 31b along the insertion direction is formed in the distal end hard portion 31 in parallel with the long hole 31a, and the connection pipe 73 projects to the proximal end side of the elongated hole 31b. It is fitted.

  In the long hole 31b and the connection pipe 73, the endoscope connector 14 is connected to the endoscope main body 1h from the distal end portion 17 through the bending portion 18, the flexible tube portion 19, the operation portion 12, and the universal cord 13. The tip end side of the elongated ultrasonic transducer cable 50 shown in FIG. Further, the ultrasonic transducer 15 configured on the distal end side of the ultrasonic transducer cable 50 protrudes from the elongated hole 31 b to the distal end side and is positioned at the distal end of the distal end portion 17.

  The ultrasonic transducer 15 has a plurality of, for example, 100 transducers and is configured as a unit. The ultrasonic transducer cable 50 includes a plurality of, for example, 100 ultrasonic vibration lines 51 (see FIG. 11) respectively connected to a plurality of ultrasonic transducers 15, for example, 100 transducers. It is configured to be bundled into one.

  As shown in FIG. 11, on the proximal end side of the ultrasonic transducer cable 50, a plurality of ultrasonic vibration lines 51 are connected to a substrate (not shown) of the ultrasonic connector 21 of the endoscope connector 14. A connector 53 is provided. In addition, the connector 53 is provided with a plurality of, for example, six in FIG.

  The guide tube 90 is inserted from the distal end portion 17 of the ultrasonic transducer cable 50 extending inside the insertion portion 11 to the operation portion 12.

  The guide tube 90 is made of a member that is flexible, has little friction, and is difficult to break, and improves the insertion / extraction of the ultrasonic transducer cable 50 when the ultrasonic transducer cable 50 is replaced. The space for arranging the ultrasonic transducer cable 50 in the insertion portion 11 is ensured.

  As shown in FIG. 3, the distal end of the guide tube 90 covers the outer periphery of the connection pipe 73 protruding from the long hole 31b on the proximal end side, and is fixed to the outer periphery.

  At this time, as shown in FIGS. 3 and 4, the notch 90k is formed at the interference portion of the tip of the guide tube 90 with respect to the tube 44, so that the interference between the guide tube 90 and the tube 44 is prevented. It is prevented.

  Further, the distal end hard portion 31 is provided with a long hole (not shown) in which an image pickup unit 16 such as an image pickup device 16 such as a CCD, an image pickup window 34 and the like is disposed, and an illumination unit made up of a light guide 60 and an illumination window 36. Long holes (not shown) to be arranged, long holes (not shown) through which the distal ends of the tubes 37c, 38c, 39c of the air supply / water supply conduit 37, the balloon water supply conduit 38, and the balloon suction conduit 39 are inserted, respectively. Is formed.

  As shown in FIGS. 9 and 10, when the long hole 31b and the long hole through which the pipes 38 and 39 are inserted are formed in the distal end hard portion 31, the long hole 31b and the pipe 38 or The distance from the long hole through which the pipe 39 is inserted is 0.5 mm or more, that is, the thickness M between the long hole 31b of the distal end hard portion 31 and the long hole through which the pipe 38 or the pipe 39 is inserted. Is formed to be 0.5 mm or more.

  In particular, when a long hole through which a fluid flows is formed, the thickness M between the long hole 31b of the distal end hard portion 31 and the long hole through which the pipe line 38 or the pipe line 39 is inserted is 0.55 mm or more. It is formed to become.

  Here, the reason why the thickness M between the long holes is 0.5 mm or more is that when the distal end hard portion 31 is made of resin, the thickness between the long holes is formed thin. This is because, when forming each long hole, damage such as cracks is likely to occur in the thin wall portion, and damage such as cracks is formed in the thin wall portion due to chemicals flowing through the long hole. That is, it is for improving the strength of the distal end hard portion 31.

  Although not shown, this means that the long hole 31b, a long hole (not shown) in which the imaging unit is provided, a long hole (not shown) in which the illumination unit is provided, or a long hole through which the tube 37c is inserted. It is the same even between.

  The distal end of the bending piece 33 constituting the bending portion 18 is fixed to the outer peripheral surface on the proximal end side of the distal end hard portion 31 by brazing or the like, and the outer periphery of the bending piece 33 is bent through a net tube 54 to be a curved rubber tube. 55. Note that the distal end of the curved rubber tube 55 is fixed to the outer periphery of the hard distal end portion 31 by thread winding or the like, and the rear end is also fixed to the outer periphery on the distal end side of the flexible tube portion 19 by thread winding or the like.

  The bending pieces 33 are rotatably connected to each other by adjacent rivets or the like (not shown). The bending piece 33 located on the most proximal side is fixed to the connecting member 88 at the boundary between the bending portion 18 and the flexible tube portion 19.

  Here, in the curved rubber tube 55, the thickness of the curved rubber tube 55 other than the thickness of the distal end portion 55s and the base end 55k fixed by bobbin winding, specifically, the second and subsequent frames of the curved piece 33 are the same. The thickness of the portion covered on the outer periphery is formed thick, and the thickness of the region 55v of the curved rubber tube 55 from the tip portion 55s to the second piece of the bending piece 33 is the same as the thickness of the tip portion 55s. Is formed.

  If the thickness of the portion covered by the outer periphery of the second and subsequent frames of the bending piece 33 is formed thick, a hole (pin) It is possible to prevent damage such as holes) from being formed.

  The thick part of the curved rubber tube 55 is defined as the second and subsequent parts of the curved piece 33. The curved piece 33 is bent from the second and subsequent pieces connected to the first piece by rivets. Because.

  Further, the portion of the curved rubber tube 55 formed thick is a portion where the bending portion 18 is narrowed in the inner diameter direction with the arrangement of the bending piece 33 in the bending portion 18. Therefore, even if the above-described portion of the curved rubber tube 55 is formed thick, the curved portion 18 does not have a larger diameter than the conventional curved portion 18 due to this.

  Further, as shown in FIGS. 3 and 4, in the endoscope main body 1 h connected to the image sensor 16, the insertion portion 11 has a bending portion 18, a flexible tube portion 19, and an operation portion. 12, an elongated imaging cable 40 extending to the imaging connector 22 of the endoscope connector 14 is inserted through the universal cord 13.

  Further, as shown in FIG. 4, the insertion portion 11 is covered with a light guide 60 covered with a protective outer tube 60c extending in the endoscope main body 1h and a protective tube 30c. Further, the tubes 37c, 38c, and 39c, each of which includes the above-described raising wire 30, the tube 44 having the treatment instrument insertion channel 23, the air / water supply conduit 37, the balloon water supply conduit 38, and the balloon suction conduit 39. In addition, for example, four bending operation wires 85 that bend the distal end portion 17 in four directions, up, down, left, and right, are disposed.

  The distal ends of the four bending operation wires 85 are fixed to the top, bottom, left and right of the distal end of the distal end rigid portion 31 or the bending piece 33, and the respective rear ends of the four bending operation wires 85 are disposed on the operation portion 12. It is wound around a bending mechanism such as a pulley (not shown).

  Thus, in the present embodiment, the introduction surface 140 of the treatment instrument elevator base 27 is in series along the insertion axis J direction and between the insertion axis J and the insertion axis J toward the distal end side. Specifically, two introduction surfaces 120 and 130 provided in series along the insertion axis J and having different angles with respect to the insertion axis J are formed. It is shown that it is composed of

  In addition, it is shown that the introduction surface 120 is formed to be an inclined surface having a smaller angle with respect to the insertion axis J than the introduction surface 130.

  Further, an arcuate groove 130m having a maximum outer diameter of the drainage tube into which the drainage tube is introduced is formed on the introduction surface 130, and the outer diameter of the puncture needle into which the puncture needle is introduced is formed on the introduction surface 120. Indicates that an arcuate groove 130m having a diameter smaller than that of the groove 120m is formed.

  According to this, when the puncture needle having a diameter smaller than that of the drainage tube is guided to the desired site by using the treatment instrument raising base 27 to direct the directing direction of the treatment instrument protruding from the channel opening 23k to the desired portion, By performing the guide using the groove 120m of the guide introduction surface 120, it is possible to guide the puncture needle without causing the puncture needle to swing within the treatment instrument insertion channel 23. The puncture needle can be accurately punctured to the site.

  Further, not only the puncture needle but also a large-diameter treatment instrument such as a drainage tube is guided by using the groove 130m of the introduction surface 130 for the puncture needle guide, so that a desired site can be obtained. Can be guided accurately.

  Therefore, regardless of whether the treatment instrument has a large diameter such as a drainage tube or a treatment instrument having a small diameter such as a puncture needle, a treatment instrument insertion channel having a different diameter for each treatment instrument is separately arranged in the insertion portion 11. Even if it is not provided, it can be accurately guided to a desired site by the treatment instrument raising base 27 of the present embodiment.

  From the above, it is possible to use a treatment instrument having a large diameter and to have a configuration capable of accurately puncturing a puncture needle at a desired site of a test site without increasing the diameter of the insertion portion 11. A sonic endoscope and a treatment instrument elevator used for the ultrasonic endoscope can be provided.

  Hereinafter, modifications will be described. In the present embodiment, a drainage tube is taken as an example for a large diameter treatment tool, and a puncture needle is taken as an example for a small diameter treatment tool.

  Of course, the present embodiment can be applied even when other large-diameter treatment tools and small-diameter treatment tools used for treatment using an ultrasonic endoscope are used. .

  Incidentally, for example, in the ultrasonic endoscope described in Japanese Patent Laid-Open No. 11-244223, the treatment tool protruded from the distal end opening of the treatment instrument insertion channel is an ultrasonic tomography at a desired site of the test site. In order to accurately capture the surface, the distal end opening of the treatment instrument insertion channel is positioned at the distal end of the insertion section so as to lead the treatment instrument into an ultrasonic scanning plane parallel to the insertion axis direction of the insertion section of the ultrasonic transducer. A configuration provided on the side is disclosed.

  In this ultrasonic endoscope, the vicinity of the distal end hard portion of the treatment instrument insertion channel is included in the central axis of the treatment instrument insertion channel and the ultrasonic scanning surface or a surface obtained by extending the ultrasonic scanning surface. The distal end opening wall formed in the distal end rigid portion provided with the distal end opening of the treatment instrument insertion channel is formed perpendicular to the ultrasonic scanning surface.

  However, in an ultrasonic endoscope having such a configuration, when the distal end opening wall is positioned perpendicular to the ultrasonic scanning surface, the ultrasonic transducer transmits the ultrasonic wave depending on the ultrasonic scanning range setting. Since the waved ultrasonic wave is reflected by the tip opening wall and is incident on the ultrasonic transducer, a virtual image may be projected on the ultrasonic image projected on the monitor.

  In particular, in the case of an ultrasonic endoscope for the purpose of performing a treatment using an ultrasonic image, since the operation of the treatment instrument is performed while viewing the obtained ultrasonic image, It is necessary to minimize the distance between the distal end opening of the treatment instrument insertion channel and the site to be examined.

  However, as a result, the tip opening wall comes close to the ultrasonic transducer, and as a result of the approach end of the ultrasonic scanning approaching the tip opening wall, the ultrasonic wave caused by the reflection of the ultrasonic wave on the tip opening wall described above. There has been a problem that the possibility of the appearance of a virtual image in the sound wave image is increased.

  In view of such a problem, in the treatment performed while observing an ultrasound image with reference to FIG. 2, FIG. 3, FIG. 12, and FIG. The configuration of an ultrasonic endoscope that can reduce the appearance of a virtual image in an image and obtain a good ultrasonic image will be described.

  12 is a partially enlarged cross-sectional view showing the tip opening wall of FIG. 3 in an enlarged manner, and FIG. 13 is a partially enlarged cross-sectional view showing a modification of the shape of the tip opening wall of FIG.

  As shown in FIGS. 3 and 12, the wall surface of the distal opening wall 200 in which the channel opening 23k of the treatment instrument insertion channel 23 of the distal rigid portion 31 is formed is transmitted from the ultrasonic transducer 15 and the distal opening is opened. The ultrasonic wave C reflected from the wall surface of the wall 200 is formed at a set angle so as to avoid the ultrasonic transducer 15.

  Specifically, the wall surface of the tip opening wall 200 is set from the end portion 200s on the ultrasonic transducer 15 side to the end portion 200k separated from the ultrasonic transducer 15 with respect to the horizontal plane 15s perpendicular to the ultrasonic scanning surface 15c. More specifically, it is formed by an inclined surface that is inclined at an angle and is directed obliquely upward as shown in FIG.

  The inclined surface is not limited to an inclined surface directed obliquely upward, and may be an inclined surface directed obliquely downward as shown in FIG.

  According to such a wall surface of the tip opening wall 200, the ultrasonic wave C reflected from the wall surface is reflected obliquely upward or obliquely downward with respect to the insertion axis J so as to avoid the ultrasonic transducer 15. That is, the ultrasonic wave C is not easily incident on the ultrasonic transducer 15 after reflection.

  Therefore, in the treatment performed while viewing the ultrasound image, it is possible to ensure good treatment properties, reduce the appearance of a virtual image in the ultrasound image due to the reflection of the ultrasound C at the tip opening wall 200, and An ultrasonic endoscope capable of obtaining a good ultrasonic image can be provided.

  In addition to the above-described configuration, as shown in FIG. 2, the tip opening wall 200 is formed from an inclined surface inclined by a set angle with respect to the surface 15w directed to the ultrasonic vibration side perpendicular to the ultrasonic scanning surface 15c. It does not matter.

  According to such a wall surface of the tip opening wall 200, the ultrasonic wave C reflected from the wall surface is only reflected obliquely upward or obliquely downward with respect to the insertion axis J, avoiding the ultrasonic transducer 15. Alternatively, since the light is reflected right obliquely forward or left obliquely forward with respect to the insertion axis J, the ultrasonic wave C is less likely to be reliably incident by the ultrasonic transducer 15 after reflection.

  According to the above configuration, in the treatment performed while viewing the ultrasonic image, it is possible to ensure good treatment properties and more reliably reduce the appearance of a virtual image in the ultrasonic image due to the distal end opening wall 200. At the same time, it is possible to provide an ultrasonic endoscope that can more reliably obtain a good ultrasonic image.

[Appendix]
As described above in detail, according to the embodiment of the present invention, the following configuration can be obtained. That is,
(1) an ultrasonic transducer that is disposed at the distal end of an elongated insertion portion and is used when imaging an ultrasonic image that is a tomographic image of a region to be examined;
A treatment instrument insertion channel formed in the insertion portion through which a treatment instrument is inserted;
A distal end opening of the treatment instrument insertion channel that projects the treatment instrument from the treatment instrument insertion channel formed at the distal end; and
In an ultrasonic endoscope comprising:
The treatment instrument insertion channel is formed in a tubular member that extends into the insertion portion and a pipe member that is connected to the distal end portion of the tubular member and communicates with the distal end opening disposed in the distal end portion. Configured,
In the ultrasonic wave, the hardness of the cylindrical member in the vicinity of the connecting portion between the pipe member and the cylindrical member is formed to be harder than the hardness of the other cylindrical member. Endoscope.

(2) The outer periphery of the tubular member in the vicinity of the connection portion is covered with a heat-shrinkable tube, so that the hardness of the tubular member in the vicinity of the connection portion is the same as that of the other tubular member. The ultrasonic endoscope according to appendix 1, wherein the ultrasonic endoscope is formed to be harder than the hardness of the part.

(3) The ultrasonic endoscope according to appendix 1 or 2, wherein an inner diameter of the pipe member in the connection portion is formed larger than an inner diameter of the cylindrical member other than the connection portion.

(4) an ultrasonic transducer having an ultrasonic scanning surface disposed at the distal end of the elongated insertion portion and parallel to the insertion axis of the insertion portion;
A treatment instrument insertion channel formed in the insertion portion through which a treatment instrument is inserted; and
A distal end opening of the treatment instrument insertion channel for projecting the treatment instrument from the treatment instrument insertion channel formed on the distal end portion onto the ultrasonic scanning surface;
In an ultrasonic endoscope comprising:
In the distal end portion, the wall surface of the distal end opening wall in which the distal end opening is formed is a set angle at which the ultrasonic wave transmitted from the ultrasonic transducer and reflected by the wall surface avoids the ultrasonic transducer. An ultrasonic transducer characterized in that it is formed.

(5) The wall surface is formed by an inclined surface inclined at a set angle from an end on the ultrasonic transducer side to an end separated from the ultrasonic transducer with respect to a horizontal plane perpendicular to the ultrasonic scanning surface. The ultrasonic endoscope according to appendix 4, characterized in that:

(6) The appendix 4 or 5 is characterized in that the wall surface is formed of an inclined surface inclined by a set angle with respect to a surface directed to the ultrasonic vibration side perpendicular to the ultrasonic scanning surface. Ultrasound endoscope.

The figure which shows the outline of a structure of the endoscope apparatus which comprises the endoscope which shows embodiment of this invention. The partial enlarged plan view of the front end side of the insertion part of the endoscope of FIG. The fragmentary sectional view of the insertion part front end side which follows the III-III line in FIG. Sectional drawing of the insertion part which follows the IV-IV line in FIG. The partial top view which looked at the treatment tool raising stand of FIG. 3 from the V direction in FIG. The partial top view which looked at the treatment tool raising stand of FIG. 3 from the VI direction in FIG. FIG. 4 is a partial enlarged cross-sectional view of an insertion portion mainly showing a connection portion between a connection pipe and a tube in FIG. 3. The partial expanded sectional view of the tube of the connection site | part vicinity of FIG. Sectional drawing of the front-end | tip part which synthesize | combines and shows the cross section which follows the IX-IX line in FIG. 3, and the cross section which follows the IX'-IX 'line. Sectional drawing of the front-end | tip part which follows the XX line in FIG. FIG. 4 is an enlarged plan view of the ultrasonic transducer cable of FIG. 3. The partial expanded sectional view which expands and shows the front-end | tip opening wall of FIG. The fragmentary expanded sectional view which shows the modification of the shape of the front-end | tip opening wall of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Ultrasound endoscope 11 ... Insertion part 15 ... Ultrasonic transducer 17 ... Tip part 23 ... Treatment instrument insertion channel 23k ... Tip opening 27 ... Treatment instrument raising stand 120 ... Introduction surface 120m ... Groove 130 ... Introduction surface 130m ... Groove J ... Insertion shaft

Claims (10)

A treatment instrument insertion channel through which a treatment instrument formed in an elongated insertion portion is inserted; and
An ultrasonic transducer disposed at the distal end portion of the insertion portion and used for capturing an ultrasonic image that is a tomographic image of a region to be examined;
A treatment instrument raising base provided by facing the distal end opening of the treatment instrument insertion channel of the distal end portion to adjust the protruding angle of the treatment instrument protruding from the distal end opening by swinging;
Comprising
On the treatment instrument raising base, at least two introduction surfaces of the treatment instrument having different angles with respect to the insertion axis of the insertion portion are provided in series along the insertion axis,
An ultrasonic endoscope characterized in that grooves of different sizes are formed for each introduction surface.   2. The ultrasonic endoscope according to claim 1, wherein the introduction surface is formed so that an angle formed between the introduction surface and the insertion shaft decreases along the insertion shaft toward the distal end side. mirror.   The ultrasonic endoscope according to claim 1, wherein the size of the groove decreases along the insertion axis toward the distal end side.   The ultrasonic endoscope according to claim 1, wherein the groove is formed in a shape having an arc.   The groove has a maximum diameter formed on the outer diameter of the treatment instrument that can be inserted into the treatment instrument insertion channel, and a minimum diameter formed on the outer diameter of a puncture needle that is punctured into the test site. The ultrasonic endoscope according to claim 4. A treatment instrument for adjusting a projection angle of the treatment instrument, which protrudes from the distal opening, provided by facing the distal opening of the treatment instrument insertion channel through which the treatment instrument formed in the elongated insertion portion is inserted, by swinging. In the upper stage,
Introducing surfaces of at least two treatment instruments having different angles with respect to the insertion axis of the insertion portion are provided in series along the insertion axis,
A treatment instrument elevator used for an ultrasonic endoscope, wherein grooves having different sizes are formed for each introduction surface.   The ultrasonic endoscope according to claim 6, wherein the introduction surface is formed such that an angle formed between the introduction surface and the insertion shaft decreases along the insertion shaft toward the distal end side. A treatment tool elevator used for mirrors.   The treatment instrument elevator according to claim 6 or 7, wherein the size of the groove decreases along the insertion axis toward the distal end side.   The treatment tool raising base used for an ultrasonic endoscope according to any one of claims 6 to 8, wherein the groove is formed in a shape having an arc.   The groove has a maximum diameter formed on the outer diameter of the treatment instrument that can be inserted into the treatment instrument insertion channel, and a minimum diameter formed on the outer diameter of a puncture needle that is punctured into the test site. A treatment instrument elevator used in an ultrasonic endoscope according to claim 9.

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